Levulan for Treatment

I just had this treatment done about 36 hours ago,...

I just had this treatment done about 36 hours ago, and I wanted to share my experience (so far) and provide updates. I did a lot of research on this treatment beforehand and part of the reading I did was from reviews here, so I thought I'd return the favor :)

A little background about me, I have cystic hormonal acne on my chin. This only started to develop over the past few years (I am 27), and my chin constantly stays red and irritated. The texture of my skin is quite bumpy, though most of the time the area never develops into a full blown breakout, it's still noticeable and not healthy looking skin. In high school I had mild acne on my cheeks and forehead, and I have been left with red marks that haven't seemed to have gone away since. In the past year or so, I've also now noticed on my cheeks raised red marks that almost look like rosacea. It almost never becomes 'broken out' but doesn't ever go away either. Lately, I have just been super depressed about the fact I am 27 and still getting breakouts. I rarely leave the house without makeup caked on my face and I absolutely HATE wearing makeup. I have tried topical treatments, blue light treatments without the levulan (which worked for approximately 9 months, then I had another round with no results) and IPL. IPL did absolutely nothing for the hyperpigmentation, which was very frustrating because it was so expensive. So I started looking into Levulan as a last resort kind of thing (I will never take accutane or any oral medication, it's just how I am).

I went in yesterday morning for the treatment and the esthetician gave me a 'light' microdermabrasion beforehand. I have never had one before and it was very irritating to my skin, but it didn't hurt or anything. Then she put the Levulan on, which stung badly. A lot of the reviews I've read said the Levulan feels cool but doesn't hurt. I don't know if this was due to the microdermabrasion I had, but it really stung. After 5 minutes or so, the stinging had greatly subsided. I sat there for 50 minutes, then washed off the medicine and went under the blue light for 13 minutes. It was a gradual buildup in pain sitting under the blue light, but it plateaued halfway through. It wasn't fun, though. However, it's not as painful as IPL. I've also had laser tattoo removal, so I figured I could handle pretty much anything. It just feels like your face is on fire, which it pretty much is.

The one issue I had was that the clinic was 45 minutes from my house and I had to drive back in the sunshine. The esthetician gave me a straw hat, though! Obagi hat, who knew. I also brought a wool scarf and put that over my face, so I had nothing exposed but my eyes. People passing me on the interstate must have thought I was crazy.

Within a few hours, I could already feel the active acne I had flattening out and becoming less noticeable. About 12 hours in, I noticed my skin had tiny amounts of liquid on the surface in places. It kind of hurt to run my finger across my cheek, so I thought it might have been some leftover crystals from the microdermabrasion, I didn't know. But apparently it is oil being pushed up from my skin, which is gross, but good since I guess that's what has been causing the problem in the first place.

Today I am still super red, but I have already noticed the raised spots on my cheeks have all but disappeared (I don't know if they'll still be red, since my whole face is still the color of a tomato, but they are no longer raised). I have had no new breakout since the treatment and the ones I had prior have been lessened significantly. So far, so good, I think. The downside, of course, is that you're stuck in the house for two whole days, and you will look awful. I did my research though, and fully anticipated the ugliness. Hopefully I can get back to normal with much better skin in a week or two.

I will continue to update and post pictures when I get a chance (or courage...I look insane). The dermatologist told me it's impossible to know whether it will require only one or multiple treatments. They are quite expensive and require a week of your time, basically, so I hope I only have to go through one, and then maybe another down the line as maintenance. I can't give a worth it/not worth it yet, obviously, but I am seeing positive results so far.

Anyway, I will keep you all updated.

Day 4: Today is the afternoon of day 4, and...

Day 4:

Today is the afternoon of day 4, and here is the bad news: I am STILL the same color red I was on day 2. I haven't seen any reduction in the redness and it is starting to irk/worry me. I know my treatment was pretty harsh compared to some others, with the microdermabrasion and the prolonged exposure to the blue light, but it's still kind of frustrating. I am so glad I'm not working currently because it would be really hard to face anybody right now. I have been seeing mild peeling since day 2, but today my face looks like it is about to peel off in its entirety. Yikes. The issue is the skin underneath seems to be the same color red as what is about to peel away.

The good news is that my active breakouts have completely disappeared. I have never seen or felt my skin so smooth. I had some whiteheads come to the surface but they quickly disappear. They have only come up in the areas I was seeing persistent breakouts, so I'm hoping the treatment has cleared up these problem areas. I will continue to update as I heal.

Day 5: Today is the end of day 5, and I think...

Day 5:

Today is the end of day 5, and I think I can say this treatment has been worth it, even if it probably isn't going to be the miracle I originally hoped for. I have tempered my expectations over the past few days from 100% elimination of hyperpigmentation and scarring to being happy that I have had no new breakouts and my skin feels wonderful. I have seen maybe 30% removal of hyperpigmentation, and I am happy with that since my main issue is with controlling the acne and not getting any NEW breakouts which would eventually become red marks in the future. I do think when the redness fades completely, I will see more reduction in the red marks, so I am looking forward to that. The best part about this treatment (besides the no new breakouts!) is that I put on makeup today and it goes on flawlessly. I have always had a problem with my makeup, no matter what brand, looking caked on my face. I never wore much of it but it still looked cakey and uneven. Now it looks awesome, although after just a little while today, my face started flaking again, so it was pointless to even wear it at all, but I had to run errands and I still look too 'sunburned' in my opinion to be in public. Also, looking at the pictures I've posted, I can definitely tell the redness has been gradually reducing since day 2, I guess I just couldn't see it in the mirror. The pictures may not really do justice, but my skin looks much better than it did before, trust me.

I will say the downtime with this treatment is ridiculous. Yes, you can technically go out in the sun after 48 hours, but it's advised not to, and you definitely will NOT want to show your face after only two days. I think I looked the worst on day 3, it was just dead cracked skin over my entire face that gradually fell off throughout the day. Gross. I would not want to be seen at work/school like that. I think I could have been alright today with makeup, but in reality, I think you need a week set aside for this to feel comfortable facing people. The healing hasn't been difficult or anything, I'm just impatiently waiting to see the final outcome. I really hope I don't need a follow-up treatment any time soon, but if it's an every 6 month thing, I would probably go for that. For those of us who do not want to take antibiotics/accutane, etc. this treatment is a great alternative.

Sorry these are so long! I am just really glad I had people's reviews to help me make a decision about the levulan treatment, and maybe this will help someone else in the future :) I will keep adding to this until I'm totally healed.

Day 13: This is my (almost) two-week review. I...

Day 13:

This is my (almost) two-week review. I have posted a few new pictures. As you can see, the hyperpigmentation still remains. So my final review of the levulan treatment is, yes, it does work. My acne was getting out of control, and every new breakout I got, it was leaving a red mark in its place. Every day, my face was getting worse. Levulan works for what it was prescribed to me for, stopping the acne. I have not had a single new breakout where the treatment was applied. I have had one or two very small pimples on my jawline, but the esthetician didn't apply any levulan in that area, so it's not for a lack of the treatment working. Now I can treat the redness the acne has left behind. I am going to look into the Fraxel treatment, but I'm not sold on it yet. I know the hyperpigmentation will fade over time, and it's easy to cover with makeup, but it's still annoying.

All in all, I highly recommend Levulan for acne treatment IF you can afford both the cost and the time out of your life, because both are significant. The down time sucks BAD, because no, you cannot resume your daily life after 48 hours even though they say you can. I went through the drive-thru at Whataburger on day 3 with my face completely covered in a scarf and sunglasses and they looked at me like I was nuts. Who wants to take a whole week of vacation to be confined in the house looking like a tomato? But, it did work for me to control my acne like nothing else I've tried before. You see immediate results which is awesome. Despite the sky-high price and the recovery process, I would do it again, and I'm sure I will if and when it gets to that point. Thanks for reading this, and if I get another treatment, I'll update again!

Day 13 (again): I forgot to add that where she...

Day 13 (again): I forgot to add that where she concentrated the levulan the most, which was on my chin, I've seen the best results. The biggest reduction in hyperpigmentation, the smoothest skin, etc. I had some really, really bad red spots on my chin leftover from cystic acne, and they really never fade much. The levulan really helped my chin the most. Looking back through the pictures I've posted, I can certainly tell an improvement. My skin is far from perfect, but at least I know it's not continually getting worse every day. Now I can fix the leftover imperfections :)

Three weeks post-treatment: Just giving...

Three weeks post-treatment:

Just giving another quick update and adding some new pics. Everything is still going well, still no new acne. I can still vaguely see where the levulan was applied because my skin is still pink, but I think it is continuing to fade, albeit slowly. It sucks my skin hasn't completely healed, but I do think I'm in the small minority who has this problem. Only one or two other people, in all the research I've done, take this long to totally heal.

Anyway, I have an appointment for a fraxel consulation next week, just to discuss the pros/cons. I really hate to go through another big procedure so soon, but I am starting a new job on Jan. 15th and I'll be working 6 days a week until April, so it'll have to be now or never. I am also going to ask the dermatologist about a Retin-A treatment. I thought I had been on a Retin-A medication for a year or longer, but it turns out it was a topical antibiotic, which doesn't do anything for the redness.

That's my update for the week! :) Thanks for the nice comments, by the way. I'm glad my experience has been informative!

Update.

Hi everyone,

I chose to delete the pictures I posted since I took a new job, and you never know who might run across things on the internet! You can still read my posts and get a feel for the results, but I have to say, they were very temporary. About six to eight weeks later, my acne was as bad as before. I had another treatment, and it worked for about another six weeks. I went back again for a third time, and it went very, very wrong. When they tell you to stay out of the sun, STAY. OUT. OF. THE. SUN! I had my third treatment done mid-day and drove myself home without the proper covering. I ended up with phototoxicity, and I was out of commission for three weeks. Thankfully, nothing was permanently scarred or burned. But it took almost a month for it to heal. However, whatever went wrong in my last treatment, it was coupled with this crazy increase in oil on my face afterward. My skin just went insane, and was so broken out. By July of 2013, I didn't even want to go to work, it was so bad.

I was eventually diagnosed with PCOS, which makes perfect sense, since my acne has only gotten worse in my late 20s. I was put on 100 mgs of spironolactone, and within two months, my skin was perfectly clear. I've been on it about 8 months now, and I am 100% breakout free! Please, if you are dealing with hormonal acne in your 20s, 30s, 40s, talk to your doctor about medicine that will balance your hormones. I didn't want to go on birth control, because I'm almost 30 and I hear it causes a lot of problems once you come off of it. Spironolactone is something you can take forever, unless you're trying to get pregnant. And you will have to take it every day, or the acne will come right back.

Topical treatments just didn't get to the root of the problem for me, unfortunately. But I found something that did, and it changed my life. I hope this helps anyone else dealing with breakouts!
Houston Plastic Surgeon

Dr. Pisarski is really nice. He spent almost a half hour with me, just talking about what to expect from the treatment, etc. I've been to other dermatologists where they look at you 30 seconds and are out the door. He answered all of my questions (and I had many!) and made me feel comfortable. He didn't actually perform the procedure, the esthetician, Marilyn, did and she is just as nice and willing to take time to discuss the pros and cons, and answer all questions. They don't push anything on you, gave me free samples of a bunch of stuff, and two complimentary blue light follow-up treatments. Very nice front office staff as well.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
4 out of 5 stars Wait tmes
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Comments (9)

thanks for sharing your process. What creams did they have you put on after your procedure ? I am going to try this next month.
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thanks for sharing your whole process. I am going to try this just for my acne scars.
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Thanks for sharing your story. I can see it was painful but the results look great! I imagine if you went through another session it could get even better!!
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do you find it decreased your pore size? gave you a better skin texture? so it definitely maded a significant amount of difference? I'm only asking because i'm from montreal and it's waaaay more expensive over here the procedure than everywhere else for some weird reason. let me know!
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I am soooo happy for you! I am 21 and seriously feel the same as you. frustuated and depressed over years and years of scars hyperpigmentation and acne. I've had two dermatologist try to convince me to do PDT, and honestly reading your long detailed post has finally given me the courage to make an appointment tomorrow morning. So you felt okay to go out in publi con day 4? or only day 5? Thank you.
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Hey! I'm sorry you're having to go through this too, it definitely sucks. I'm glad you're making an appointment! It has really helped me a lot. As for the going out, like I said in my last post, I think it's taking me a lot longer to heal than most people, and I had a pretty extreme treatment. From what I've heard, most docs leave the medicine on for an hour then you sit under the light for like 5 minutes. I sat for 12 AND had the microderm beforehand, which made it even more intense. But to answer your question, I went out on day 4 and ran a couple errands. I put makeup on beforehand and I looked...okay. I did not look GOOD by any means, but I guess I'd liken it to putting makeup on over a peeling sunburn. By the time I got back to the house a few hours later, all the makeup/skin was flaking off. If I would've had to go to work or see people I knew, then I wouldn't have felt comfortable, but just going out to the grocery store or something, you'll be fine. Day 5 was still peely but way less than day 4. It is a pretty long, grueling process, though. Good luck, let me know how it goes!
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How AWESOME that your makeup is going on so well!! I bet its a time saver for you too, or at least I notice when my skin is "good" I save about 10 mins off my morning routine as opposed to when have to spend a ton of time trying to make my skin look normal.

Any other changes over the last couple of day?

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Thanks for the comments. And yes, it is super frustrating when I have breakouts. I have tried every concealer product, cheap and expensive and I swear they still all look clumpy and gross on my face, like I am just trying to cover something up. It's so annoying! Thankfully, this has given me a little relief from that. So far, so good!
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I love the visual of you bundled up in a scarf & a straw hat cruising down the highway, haha too funny! I'm glad you were covered though!!

Thank you so much for sharing so much detail in your review. You definitely know what people are curious to know, and you have addressed it all so far!

When I read about your frustration with having acne still at 27 I could soooo relate. I really hope this gives you a great result. Looking forward to hearing more from you!!

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